Archive for March, 2014

Not only is it a big weekend for March Madness basketball, it’s a big weekend for the health insurance industry as well. March 31 is the deadline to sign up for health insurance or else risk receiving a penalty by the government when you file your taxes next year. As long as you have started filling out a health insurance application, there is a grace period until April 7 to finish filing your paperwork. The Associated Press offered important information in their article, “Monday is the deadline to sign up for health law”. Government reports say that more than 6 million people have already signed up for health insurance through the newly created marketplaces since they opened October 1. That number doesn’t even take into account the number of people who have signed up for new health insurance plans outside of the marketplaces since the new law took effect. Four out of five of the people signing up in the marketplace have gotten a government tax credit to help pay for their premium cost.

The federal government’s website has a deadline of midnight on March 31, but states that are running their own marketplaces might have different deadlines in place. You can sign up online, by phone, or even in person because many local areas have sign-up centers. Since we are down to the wire with sign-up time, there will probably be long wait times no matter which way to choose to sign up through Monday. If you don’t qualify for a government tax subsidy, but want to get health insurance to follow the law, there are many more options for finding health insurance. You can compare health rates for individual or family insurance plans here.

In Tennessee, there is a “Local push underway to get health insurance before (the) deadline“. Local ABC News affiliate WATE reporter Kayla Strayer posted a list of locations where people in East Tennessee can receive free help from insurance agents. One out of six people in Tennessee has been living without health insurance. Most of these people say that they simply can’t afford it. Insurance experts are helping many of these Tennesseans determine whether they qualify for government subsidies as well as helping them with the application process. One volunteer says that you can see the relief on people’s faces when they find a health insurance plan that they can afford. Many have been going without health insurance, and in turn doctor visits and tests, even though they know they need treatment. Americans have to sign up for health insurance by March 31, or risk being charged a fee. Fees are equal to 1% of your income, or $95 per adult and $50 per child. Some Americans will be exempt from this insurance mandate.

The country has been very focused on uninsured Americans over the past couple of years. Another important issue that is rarely discussed is how many people are actually underinsured. U.S. News & World Report’s Kimberly Leonard discussed research from the Commonwealth Fund in her article, “Report Highlights Underinsured by State”. The Commonwealth Fund’s report is called “America’s Underinsured: A State-by-State Look at Health Insurance Affordability Prior to the New Coverage Expansions”. When looking at Americans under the age of 65, one out of every eight is underinsured. This means that although they do have health insurance, they still pay a high percentage out of pocket for health care costs. Many underinsured Americans end up filing for bankruptcy because of their health care bills. They are also at a high risk of ignoring symptoms and avoiding the doctor.

States with the lowest rates of underinsured Americans were in the Northeast and the upper Midwest. The Southern and Western states had the highest rates. New Hampshire’s underinsured rate of 8% was the lowest in the nation. Some of the other states with low rates include Minnesota, Maryland, and Massachusetts. The highest underinsured rate of 17% belongs to both Idaho and Utah. Both Tennessee and Mississippi had underinsured rates of 16%. When the report looked at the combination of uninsured and underinsured Americans, the highest numbers of uninsured and underinsured Americans were in New Mexico and Texas. Middle income Americans in Wyoming and Alaska suffer the most from being uninsured or underinsured. One-third of the middle income population in those states falls into the uninsured or underinsured category. The lowest uninsured and underinsured rates were in Connecticut, Massachusetts, Minnesota, and the District of Columbia. These states had combined rates less than 20%.

Deductibles, premiums, household income, and insurance status were taken into account for the report results. Lower income households, earning less than $47,000 per year for a family of four, are considered underinsured if they spend more than 5% of their yearly income on health care costs. Middle income households, earning between $47,000 and $95,000 per year, are underinsured if more than 10% of their annual income is spent on health care. The Commonwealth Fund report found that $32 million Americans are underinsured, $4 million of whom come from middle income families. It also showed that 47 million Americans were uninsured in 2012. Obviously this data was collected before the Affordable Care Act went into effect. It will be a good comparison for the next few years to see if the ACA makes the changes that it set out to make in “fixing” our health care system. The number of uninsured Americans has certainly gone down, and the number of underinsured Americans should as well. Since insurance companies can no longer discriminate against those with preexisting conditions and they must offer affordable plan choices, fewer Americans may be underinsured in the future.

Unless you’re made of money, it’s really important to pay attention to the health care providers you see. In-network and out-of-network may just seem like insurance terms, but if you you make the decision to seek health care that is out of the network established by your health insurance plan, you might end up paying a lot of money out of pocket. In the Kaiser Health News article, “Warning: Opting Out Of Your Insurance Plan’s Provider Network Is Risky,” Michelle Andrews gives us the run down on what to expect out-of-network. There are a lot of health insurance plans, especially in the new health insurance marketplaces, that offer consumers lower premium costs if they choose a network of health care providers that is more limited. Some people opt for these plans with the assumption that they will simply go out-of-network if necessary and pay the added costs. They may not know just how much those added costs will be though.

The Affordable Care Act has put limits on the out of pocket costs that Americans will have to pay each year. For 2014, the limits are $6,350 for individuals and $12,700 for families. These maximum out of pocket costs are only for in-network care though. Most health insurance plans can charge you much more if you go out-of-network. Some companies don’t even have a cap on your out of pocket costs when you go out-of-network. Annual check-ups, vaccines, cancer screenings and other preventative care are now free for most Americans with health insurance plans. But if you choose to receive these services from a provider out of your network, you will likely pay for these otherwise “free” services. Health insurance companies often charge consumers higher co-payments and coinsurance for care that they receive out of their network. In addition to that, doctors and hospitals can charge you what is known as “balance billing” when they are out of your insurance company’s network. Since they aren’t in a contract with your insurer, many out of network doctors and hospitals will send you a bill for any charges that your insurance did not cover.

This in-network versus out-of-network cost structure holds true for Americans who purchased health insurance through the marketplaces, those with individual health insurance plans, and even workers who receive health insurance plans through their employer. You would be hard pressed to find a health insurance plan that covers care at any doctor or hospital. The four levels of plans in the health insurance marketplace are bronze, silver, gold and platinum. They cover 60, 70, 80 and 90% of your medical services, respectively. But those percentages only account for in-network care, something you have to keep in mind when choosing providers. When taking a look at the silver plans specifically, 70% of them are considered narrow network, which means that 30% of the largest hospitals in your area will not be in-network. With ultra narrow network plans, 70% of the largest hospitals in your area are out-of-network. Emergency care will be covered because of a stipulation in the health care law, regardless of where you receive care. Insurance companies cannot charge you higher co-payments or coinsurance if you are out-of-network, which is probably why most emergency room co-payments are so high to begin with. But if you end up being admitted to an out-of-network hospital after your emergency room visit, you might want to seek a transfer to an in-network provider because you are no longer protected by the emergency care stipulation.

A Kaiser Family Foundation study found that more than half of people who purchase their own health insurance plan are willing to take a smaller network of providers in exchange for lower premium costs. They also found that there is little standardization when it comes to individual and marketplace health insurance plans. Do your research and call your insurer with every visit if you need to, just to make sure that your health care will be covered. If you are looking for health insurance quotes, compare health rates offers quotes from multiple insurers all over the United States.

While we are the United States of America, we are made up of a wealth of different cultures and backgrounds. Some health insurance marketing fails to take that fact into account. In “Selling Health Care To California’s Latinos Got Lost In Translation,” NPR Station WCAI discusses the nuances with the Latino culture and health care. The article specifically looks at California because 30% of the state speaks Spanish. Unfortunately for many advertisers and health insurance companies, simply translating an English slogan or commercial to Spanish does not work. Covered California, the state insurance exchange, started advertising benefits of the new health insurance laws that don’t actually appeal to many Hispanics. Advertising the importance of not being denied coverage for pre-existing conditions is great for most Americans. Many people have been denied individual health insurance or know someone who has. But this article says that the majority of Hispanics in California not only have never even been insured, they also haven’t even shopped around for health insurance because they didn’t consider it. Having health insurance isn’t typically a norm in their culture.

Another problem with the Covered California Spanish advertising is that the commercials end by listing a website to visit, but no phone number or address. Latinos are all over the internet, but research has shown that they don’t prefer to do transactions online. They would rather speak to someone on the phone or in person. This especially holds true for purchasing health insurance because it can be complex, confusing, and many of them have never had health insurance before. Officials say that they have been working on offering more locations for Latinos, as well as other residents, to be able to physically go somewhere and speak with someone about their health insurance options.

The Covered California name itself doesn’t really translate to something exciting and the ads have been perceived as “dry”, exactly the opposite of the Latino culture. It’s seems simple as an outsider to see that you need to market your insurance plans differently to different cultures. And in California, when 30% of the population is Spanish speaking, you have to account for that and the differences in the Latino culture. It matters to the general population if Latinos sign up for health insurance coverage. Why? Latinos are younger and healthier, on average, so when they are in health insurance pools overall premium costs are lower for everyone else. Only 6% of those who have signed up for the new California health insurance speak Spanish as their first language. While the March 31 deadline for coverage sign-ups is fast approaching, an overall improvement in marketing strategy will help Latinos and the health care industry as a whole.